This scale has to be capable to assess the functional ability from his first day in hospital, requiring a fine tuned scale, assessing the patient from completely bed-ridden (e.g. In a health care system, aiming at shorter hospital stay despite shortening in personal resources, a more detailed scale is required to adequately target specific interventions. Furthermore, most scales require a certain amount of mobility, e.g. Other scales like the de Morton Mobility Index (DEMMI) or the Functional Status Score for the Intensive Care Unit (FSS-ICU) are valid and reliable tools for assessing mobility but only in a specific group of patients (older than 65 years) or in a specific setting (geriatric setting, not acute care setting, ICU). detected only small floor and ceiling effects for the FIM for most items and most patients suffering from 20 diverse impairment categories. Cohen and Marino reported on floor and ceiling effects of the BI in post stroke patients and patients with recent hip fractures, as well as substantial ceiling effects of the FIM cognition items in patients at rehabilitation discharge with spinal cord injuries. These limitations have been reported for the Timed Up and Go test (TUG), the Functional Reach Test (FRT), and activities of daily living scales such as the Barthel Index (BI) and Functional Independence Measure (FIM). įloor and ceiling effects are the major problems of existing tools for assessing mobility in the acute care setting. Patients with impaired mobility stayed in the hospital longer and presented a higher mortality rate. A highly significant correlation was found between mobility and length of stay in hospital and mortality rate. In 2009, the mobility of 500 Inpatients (aged between 20 and 99 years) was evaluated in a multicenter study in different hospitals in Vienna. One of the most important aspects of functional decline during hospitalization is reduced mobility which may have an impact on independence and quality of life. Diminished independence is associated with an increased risk of transfer to nursing home, caregiver burden, mortality and healthcare costs after discharge especially of older patients. Early mobilization of patients in the acute care setting is of utmost importance to decrease length of stay and avoid permanent impairments. The functional decline of patients has been reported as a result of hospitalization and is pronounced in the older population. It is easy to apply, sensitive to change during the hospital stay and not vulnerable to floor and ceiling effects. The BMS may be used as a reliable and valid tool for the assessment of mobility in the acute care setting. At admission, the BMS was less vulnerable to floor effects. The BMS proved to be sensitive to improvements in mobility (Wilcoxon’s signed rank test: p < 0.0001 The effect size for the BMS was 1.075 and the standardized response mean 1.10. The criterion-concurrent validity was high to excellent (Spearman correlation coefficient: −0.91 in correlation to FIM) and the internal consistency was good (Cronbach’s alpha 0.88). The BMS showed an excellent inter-rater reliability for the total BMS (ICC BMS: 0.85 (95 % CI: 0.81–0.88). One hundred twenty-five patients (79 women/46 men) were included. Furthermore, floor and ceiling effects were determined. Inter-rater reliability, criterion-concurrent validity, sensitivity to change, and internal consistency were calculated. Furthermore pain, length of stay in hospital, and post-discharge residential status were recorded. Assessment of subscales of the Functional Independence Measure (FIM) and the ICF based Basic Mobility Scale (BMS) were performed at admission and before discharge. In a prospective study inpatients in the acute care setting with restricted mobility aged above 50 years assigned to rehabilitative treatment were included. The aim of the study was to examine the inter-rater reliability, the validity, the sensitivity to change, and the internal consistency of an ICF based scale. The assessment of mobility is important in the acute care setting.
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